Respiratory muscle strength training: treatment and response duration in a patient with early idiopathic Parkinson's disease.

The outcome of a 20 week expiratory muscle strength training program (EMST) is documented in a patient with early idiopathic Parkinson's disease. A pressure threshold device was utilized and training occurred in the home setting. The training was intensive with a physiologically challenging load specific to the expiratory muscles, adjusted weekly based on the participant's performance. Results indicated that strength, as indexed by the generation of maximum expiratory pressure (MEP), increased by 50% in the first 4 weeks of training, consistent with the average strength increase obtained in previous research. Strength increases continued beyond the traditional 4 weeks of training with a final improvement in MEP of 158% from baseline over the 20 weeks. When the EMST was discontinued for a period of 4 weeks, the participant's MEP decreased by 16% from the 20 week endpoint measurement. The strength training pattern of the expiratory muscles observed in this study was similar to the pattern previously reported for limb muscles.